Acceptability of Early Infant Male Circumcision as an HIV Prevention Intervention in Zimbabwe: A Qualitative Perspective

Mavhu, Webster; Hatzold, Karin; Laver, S; Sherman, Judith; Tengende, Brenda R.; Mangenah, Collin; Langhaug, Lisa; Hart, Graham; Cowan, Frances M

doi:10.1371/journal.pone.0032475

Cited by 43 publications

(56 citation statements)

References 24 publications

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“…Such a finding is similar to that noted by Ngalande, Levy, Kapondo, and Bailey (2006), Westercamp and Bailey (2007), Plank et al (2010), and Mavhu et al (2012). However, what is new in this study is the concern about the lack of insurance in case of an accident or a mistake during the surgical operation of VMMC.…”

Section: Discussionsupporting

confidence: 90%

Men's attitudes: A hindrance to the demand for voluntary medical male circumcision – A qualitative study in rural Mhondoro-Ngezi, Zimbabwe

Moyo

Mhloyi

Chevo

et al. 2015

Global Public Health

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Male circumcision has witnessed a paradigm shift from being regarded as a religious and cultural practice to a global intervention strategy meant to curb transmission of HIV. This is particularly evident in sub-Saharan African countries where the HIV prevalence is greater than 15%. Zimbabwe adopted the voluntary medical male circumcision (VMMC) strategy in 2009; however, since then the uptake of the intervention has only 10% of the adult male population has reported having been circumcised. To better understand this limited uptake of VMMC, we conducted a qualitative study with uncircumcised men aged 15-79 years in Mhondoro-Ngezi, Zimbabwe. Through assessing men's attitudes towards VMMC in seven focus group discussions, conducted between July and August 2012, this article seeks to provide improved strategies for delivering this intervention in Zimbabwe. These data reveal that, in general, men have a negative attitude towards VMMC. Specific barriers to the uptake of VMMC included the perceived challenge to masculinity, post-circumcision stigma, lack of reliable and adequate information and perceptions about the appropriateness of VMMC. These results suggest that structural interventions aimed at reducing stigma related to circumcision, in addition to increased efforts to disseminate accurate information about VMMC, are required in order to dispel men's attitudes that hinder demand for VMMC.

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Section: Discussionsupporting

confidence: 90%

Men's attitudes: A hindrance to the demand for voluntary medical male circumcision – A qualitative study in rural Mhondoro-Ngezi, Zimbabwe

Moyo

Mhloyi

Chevo

et al. 2015

Global Public Health

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“…Based on this evidence and the fact that most parents (84.2%) would like to know the health benefits of circumcision, as suggested in the present investigation, we speculate that the willingness and acceptance of EIMC would increase in China if the parents of newborns were provided with sufficient information about EIMC (especially the father, who usually has the final say [66.7%]), which is consistent with the findings in reports from other countries [9,19,24]. Indeed, education about EIMC can be easily achieved through free booklets and lectures aimed at the father-to-be.…”

Section: Discussionsupporting

confidence: 90%

“…Even so, the fear of pain and the risk of the procedure were reported to be the major barriers to EIMC [9,10,23]. Therefore, EIMC should be done safely to increase acceptance by parents.…”

Section: Discussionmentioning

confidence: 99%

Acceptability of early infant male circumcision among chinese parents: strategy implications of HIV prevention for china

et al. 2012

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BackgroundRecent evidence has confirmed that circumcision can be performed as a preventive strategy for HIV and early infant male circumcision (EIMC) is regarded to be safer than circumcision in adulthood; however, limited data are available in the literature about EIMC in China. Therefore, the present study was designed to determine the willingness and attitudes of Chinese parents on newborn male circumcision so as to provide data for exploring the feasibility of implementing EIMC as an HIV prevention strategy in China.MethodsSimple random sampling was used to draw participants from parents who had a newborn son delivered at Nanjing Maternity and Child Health Care Hospital, which is affiliated to Nanjing Medical University, between March and December 2010. A questionnaire was used to determine general medical knowledge or information about circumcision, attitudes about EIMC, and level of decision-making on circumcision for the newborn son.ResultsData derived from 558 responses were analyzed and the ratio of respondents was 56.3% for fathers and 43.6% for mothers. Of the respondents, 34.4% agreed to circumcise their newborn son, and the level of agreement was 3.25 ± 1.17 (range, 1–5 with “1” being “reluctantly agree” and “5” being “very strongly agree”). The major reason for EIMC was for health (44.8%), followed by doctor’s advice (31.2%). The major reason not to agree to EIMC was concern about pain (50.5%), followed by the risk of the procedure (23.5%).ConclusionThe willingness and acceptability of EIMC in China is low and the parents of newborn sons are usually not very affirmative when making a decision on such a procedure, suggesting that significant effort will be needed if EIMC is to be implemented as an HIV prevention strategy for China.

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“…The first study (conducted in 2010) explored hypothetical acceptability of EIMC among parents and the wider family through focus group discussions (FGDs) [23]. The follow-up study (conducted in 2013) explored actual acceptability of EIMC among parents who had either opted or declined to have their newborn son circumcised.…”

Section: Methodsmentioning

confidence: 99%

Unpacking early infant male circumcision decision-making using qualitative findings from Zimbabwe

Mavhu

Hatzold²,

Ncube

et al. 2017

BMC Int Health Hum Rights

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BackgroundEarly infant male circumcision (EIMC) has been identified as a key HIV prevention intervention. Exploring the decision-making process for adoption of EIMC for HIV prevention among parents and other key stakeholders is critical for designing effective demand creation interventions to maximize uptake, roll out and impact in preventing HIV. This paper describes key players, decisions and actions involved in the EIMC decision-making process.MethodsTwo complementary qualitative studies explored hypothetical and actual acceptability of EIMC in Zimbabwe. The first study (conducted 2010) explored hypothetical acceptability of EIMC among parents and wider family through focus group discussions (FGDs, n = 24). The follow-up study (conducted 2013) explored actual acceptability of EIMC among parents through twelve in-depth interviews (IDIs), four FGDs and short telephone interviews with additional parents (n = 95). Short statements from the telephone interviews were handwritten. FGDs and IDIs were audio-recorded, transcribed and translated into English. All data were thematically coded.ResultsStudy findings suggested that EIMC decision-making involved a discussion between the infant’s parents. Male and female participants of all age groups acknowledged that the father had the final say. However, discussions around EIMC uptake suggested that the infant’s mother could sometimes covertly influence the father's decision in the direction she favoured. Discussions also suggested that fathers who had undergone voluntary medical male circumcision were more likely to adopt EIMC for their sons, compared to their uncircumcised counterparts. Mothers-in-law/grandparents were reported to have considerable influence. Based on study findings, we describe key EIMC decision makers and attempt to illustrate alternative outcomes of their key actions and decisions around EIMC within the Zimbabwean context.ConclusionsThese complementary studies identified critical players, decisions and actions involved in the EIMC decision-making process. Findings on who influences decisions regarding EIMC in the Zimbabwean context highlighted the need for EIMC demand generation interventions to target fathers, mothers, grandmothers, other family members and the wider community.

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Acceptability of Early Infant Male Circumcision as an HIV Prevention Intervention in Zimbabwe: A Qualitative Perspective

Cited by 43 publications

References 24 publications

Men's attitudes: A hindrance to the demand for voluntary medical male circumcision – A qualitative study in rural Mhondoro-Ngezi, Zimbabwe

Men's attitudes: A hindrance to the demand for voluntary medical male circumcision – A qualitative study in rural Mhondoro-Ngezi, Zimbabwe

Acceptability of early infant male circumcision among chinese parents: strategy implications of HIV prevention for china

Unpacking early infant male circumcision decision-making using qualitative findings from Zimbabwe

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